What Are Punctal Plugs?

What Are Punctal Plugs?

A diagram of the lacrimal apparatus

Anyone who has experienced dry eye symptoms knows how frustrating it can be to achieve relief. Artificial tears are a great way to combat symptoms, but the relief they offer is temporary. For those struggling with moderate to severe dry eye syndrome (DES), eye doctors may recommend punctal plugs. These small medical devices are an effective way to reduce the symptoms of DES that can’t be treated with eye drops alone. In this blog, we’ll discuss how punctal plugs work and when you should talk to your doctor about this dry eye treatment. 

What are puncta?

The puncta are small openings located on the top and bottom eyelids, near the nose. Their function is to drain excess tears away from the eyes through the body’s drainage system and into the nose. For most people, this is a necessary function to keep the eyes from getting too much moisture. But for people who struggle with dry eyes, keeping that moisture in the eye is critical. 

How do punctal plugs Work?

Punctal plugs do just what their name suggests: they plug the puncta! This prevents tears from draining out of the eye, keeping their moisture on the eye’s surface. Punctal plugs are available in 2 types: Temporary and Semi-Permanent. Temporary plugs are made from collagen, a dissolvable material which is broken down and absorbed by the body within a few months. Semi-permanent plugs are made from silicone. These plugs are designed to be left in the eye for many years, or permanently. 

Both types of plugs are inserted into the puncta by an eye doctor. Your doctor may place a numbing drop on your eyes. She will then place the plugs, which are approximately the size of a grain of rice, into the puncta using a special tool. This procedure is done in the exam room and only takes a few minutes. It is not painful, and you can resume normal activities immediately. 

Punctal plugs are considered an effective treatment for most people suffering from dry eye  syndrome. A report by the American Academy of Ophthalmology found that plug placement resulted in ≥50% improvement of symptoms, improvement in ocular-surface health, reduction in artificial tear use, and improved contact lens comfort in patients with dry eye.

Are there any risks?

Like any procedure, punctal plugs do have some risks. The most common complications are irritation, infection, and plug loss (plug falling out of the eye). If the plugs cause irritation or become infected, they can be removed easily in the office by your eye doctor. If the plugs fall out, your eye doctor may replace them with a larger plug. It is important to talk to your eye doctor about all possible risks before deciding if this procedure is right for you.

Are punctal plugs for me?

Punctal plugs are a good option for many people with DES. They have been shown to be safe and effective in a number of trials, with up to 94.2% reduction in dry eye scores. If you struggle with symptoms of dry eye syndrome, your eye doctor can help you decide if punctal plugs are right for you. To schedule an appointment with an eye doctor, call (907) 328-2920. To learn more about dry eye syndrome, visit the Dry Eye section of our website at https://mountainvieweyes.com/dry-eye/.

Written By: Gina Stafford COA, LDO, ABOC


Marcus M. Marcet, MD et al., ‘Safety and Efficacy of Lacrimal Drainage System Plugs for Dry Eye Syndrome’, Ophthalmology, V. 122, issue 8, P1681-1687, 2015.


Nava-Castaneda A, Tovilla-Canales JL, Rodriguez L, Tovilla Y Pomar JL, Jones CE. Effects of lacrimal occlusion with collagen and silicone plugs on patients with conjunctivitis associated with dry eye. Cornea. 2003 Jan;22(1):10-4. doi: 10.1097/00003226-200301000-00003. PMID: 12502940.

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